Individual provider Active NPI

Leah Michelle Missal, COTA

  • Occupational Therapy Assistant
  • Altamonte Springs, FL
National Provider Identifier
1558085365
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
19007 Issued in FL
Practice address
395 Wymore Rd Apt 105
Altamonte Springs, FL 32714-5110
Phone
(407) 300-7319
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 19007 FL
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 19007 FL Primary

Addresses

Primary practice location

395 Wymore Rd Apt 105
Altamonte Springs, FL 32714-5110

Mailing address

395 Wymore Rd Apt 105
Altamonte Springs, FL 32714-5110
Phone (407) 300-7319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19007FLMDPediatric Sports Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1558085365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 WYMORE RD APT 105",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145110",
            "telephone_number": "407-300-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 WYMORE RD APT 105",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145110",
            "telephone_number": "407-300-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSAL",
        "first_name": "LEAH",
        "middle_name": "MICHELLE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "FL",
            "license": "19007",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "19007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.